Αρχειοθήκη ιστολογίου

Αλέξανδρος Γ. Σφακιανάκης
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5
Άγιος Νικόλαος Κρήτη 72100
2841026182
6032607174

Τρίτη 5 Σεπτεμβρίου 2017

Pediatric tympanic membrane cholesteatoma: Systematic review and meta-analysis

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Publication date: November 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 102
Author(s): Harry H. Ching, Alycia G. Spinner, Matthew Ng
IntroductionTympanic membrane cholesteatoma (TMC) is a rare anomaly found in pediatric patients with no significant otologic history. Its pathogenesis appears distinct from congenital mesotympanic cholesteatoma. This systematic review and meta-analysis evaluates the management of TMC.MethodsTwo authors independently conducted a systematic review using the PubMed-NCBI, Cochrane Library, and Web of Science databases. Studies describing cases of pediatric TMC were included. Patients with history of chronic otitis, otorrhea, trauma, or otologic surgery were excluded.ResultsSeventeen articles were included for a total of 45 patients. Mean age was 35.9 months with 56% female. Patients aged ≥36 months had significantly larger cholesteatomas than younger patients (4.2 vs 1.9 mm, p = 0.004). Nine patients (20%) had middle ear extension but none had middle ear or ossicular disease. CT scans influenced management in 1 of 26 patients. All patients were managed surgically by transcanal approach (93%) or retroauricular approach (7%). Surgery involved enucleation without TM perforation (80%) or complete excision with TM grafting (20%). In 23 patients, the fibrous TM remained intact, and there were no recurrences in this group at a mean follow-up of 11 months. Overall, there was 1 recurrence (2%), eventually requiring reoperation. No patients experienced persistent tympanic membrane perforation, chronic otitis, or hearing loss.ConclusionTMC occurs in pediatric patients without an otologic history. Associated middle ear involvement has not been reported. CT scanning may not be necessary for work up and management of this disorder. A transcanal approach with enucleation is often sufficient treatment. Risk of recurrence appears lower than with congenital mesotympanic cholesteatoma.



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